Mitzi Kim Dusin, MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT00213 Issued in RI

Practice address

1800 New London Tpke
Apt. E-10
West Warwick, RI 02893-5448

Phone

(401) 823-1275

Fax

(401) 874-4804

NPI assigned

Mar 12, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477685865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 NEW LONDON TPKE",
            "address_2": "APT. E-10",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028935448",
            "telephone_number": "401-823-1275",
            "fax_number": "401-874-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NEW LONDON TPKE",
            "address_2": "APT. E-10",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028935448",
            "telephone_number": "401-823-1275",
            "fax_number": "401-874-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSIN",
        "first_name": "MITZI",
        "middle_name": "KIM",
        "name_prefix": "Ms.",
        "credential": "MS, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "RI",
            "license": "AT00213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in West Warwick, RI
• Providers in West Warwick, RI by specialty
• Athletic Trainer in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.